Mercy Clinic Springfield Communities
Organization Active NPI Rural Health Clinic/Center · Republic, MO
NPI 1962534727 · NPPES record last updated Jun 11, 2018
Key facts
- NPI
- 1962534727
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- MERCY CLINIC SPRINGFIELD COMMUNITIES
- Practice address
- 332 S Main Ave
Republic, MO 65738 - Phone
- (417) 732-5050
- Fax
- (417) 732-8061
- NPI assigned
- Mar 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Stuart Stangeland
- Title
- Senior Vice President
- Phone
- (417) 820-3873
Other NPIs on the same Medicare enrollment 29
Practitioners 3
-
Oakley B. Downing, M.D.
-
Angela R. Limpus, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031218000354 | MO | Part B Supplier - Clinic/Group Practice | 7416865845 |
Receives reassigned benefits from 1,639 practitioners 29 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 107047 | MO | |
| Rural Health Clinic/Center | 261QR1300X | MO | Yes | |
| Physician Assistant |
363A00000X | 2001029957 | MO | |
| Family Nurse Practitioner |
363LF0000X | 145564 | MO |
Addresses
Primary practice location
332 S Main Ave
Republic, MO 65738
Mailing address
645 Maryville Centre Dr FL 3
Saint Louis, MO 63141-5855
Phone (417) 820-7133
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 596051300 | Medicaid | MO |
Other names
- Mercy Clinic Family Medicine-Republic
Other providers in Republic, MO
- Sara B. McCalley
- Stephen L McClanahan II
- Rachel D McElfresh
- Matthew Charles McNitt
- Kevin Edward Medlin
- Mercy Hospital Aurora
- Elise Mitchell
- Amanda Morelock
- Elizabeth A. Mullings
- N & R of Christian Republic LLC
All providers in Republic, MO · Rural Health Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.